...Medical equipment Having medical supplies like breathing equipment and others, delivered to your home. Quantity limits and prior authorizations are waived. This includes: medical supplies such as diabetic supplies, incontinence...

...must complete the HIPAA Authorization Form and send it to us via fax or mail. Please allow up to 30 days to process the request. You must return the completed...

...Vision References Learn more about topics like covered routine vision services, claims submissions and prior authorization requirements and processes. Superior Vision Website Visit this link to contract with Superior Vision....

...formulary If prior authorization, quantity limits and/or step therapy restrictions are added for a drug If a drug is moved to a higher cost-sharing tier If the FDA deems a...

...Drug List Prior Authorization Criteria – For certain drugs, your doctor will need to contact us before you can fill your prescription. 2025 Prior Authorization Criteria Last updated on 12/01/2025...

...benefits on a certain drug, you can request a coverage determination. If your prescription requires approval (prior authorization) prior to being filled, you will get a written notice explaining how...

...in the first 90 days of your membership and your medication is not on our covered drug list (formulary) or coverage is limited in some way, such as prior authorization,...

...limitations. This may include requiring a prior authorization, step therapy, or quantity limit. The prior authorization requirements for your medicines may change. Questions? Call Member Services. The comprehensive formulary, pharmacy...

...key services — such as Primary Care and some Prescription Drugs — prior to having to satisfy your deductible. If you don’t expect to have many doctor appointments or need...

...any coverage limitations like prior authorization or step therapy restrictions. CareSource helps you pay for covered prescription drugs and prescription medical supplies at the pharmacy. You may have a deductible...